Around the Island

The doctor is in: The binge-drinking heart throb

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Abundant alcohol intake is well known for its damage to the heart and liver, but evidence grows that it’s strongly associated with heart throbs.

No. Not that kind.

New onset palpitation, especially around the holidays, have been related to binge drinking and is endearingly termed, “the Holiday Heart Syndrome.” Cardiologists nation-wide are cautiously preparing for the arrhythmias that summer drinking brings. Dr. Jyoti Ganguly, founder of Island Cardiovascular Associates, LLP recetnly said, “The incidence of new onset Holiday Heart Syndrome is huge. Thirty percent of new onset atrial fibrillation is caused by alcohol usage. In the young, with no other causative factors, 60% of atrial fibrillation is due to alcohol abuse.”

Important to know is that most arrhythmic palpitations resulting from binge drinking is atrial fibrillation. Many of us are knowledgeable of atrial fibrillation since it’s common and often addressed in pharmaceutical commercials advertising the newest blood thinning breakthrough. And for good reason. Atrial fibrillation is a known cause of debilitating brain strokes cause by clots formed in a fibrillating heart.

With the knowledge that binge drinking can lead to more than just a bad headache, let’s address the symptoms and how it can be treated a home. But first, the science.

Alcohol, consumed as more than one standard drink (1.5 oz hard liquor, 5 oz wine, 12 oz beer) in one hour, gets us drunk. Scientifically speaking, drunk is a physical and emotional state experienced when the alcohol intake is faster than it can be metabolized by the liver. In trying to metabolize the consumed alcohol (ethanol), the liver converts it into an even more toxic form called ethanal, before further breaking it down into the commonly used food additive called acetic acid.

In binge drinking, the blood alcohol level rises too high and too fast such that the level of the toxic ethanal is also increased. In effect, while ethanol is having you do the limbo, ethanal is carcinogenically damaging your DNA and increasing dysfunctional rhythms in your heart.  

The legally drunk blood alcohol level (BAC), of 0.08 equates to our body’s overall blood volume being 0.8% alcohol. The number of drinks needed to raise the blood alcohol level to legal limits will depend on the individual’s current blood volume ( i.e, dehydration status), the strength of the drink and how effective the individual’s liver is in getting rid of alcohol.

The average 150-pound male has 1 gallon of blood volume and will take approximately an hour to process the alcohol in one beer. A single beer (6% alcohol by content) then has the potential of raising the body’s BAC to 0.07 (0.7%). Many of us drink to reach that happy and relaxed sweet spot and then continue drinking in hopes of maintaining that level. However, since we rely on our feelings, by the time we start to feel drunk, we have blown past the legal limit of 0.08 (0.8% and drunk) and onto a BAC of 0.2 (2% and skunk drunk). At a BAC of 0.3 (3%), the blood is poisoned, and life is threatened.

The legally drunk BAC level of 0.08 (0.8%) coincides with the initiation of the abnormal cardiac rhythms seen in Holiday Heart Syndrome. These symptoms worsen as alcohol levels rise and include racing heart, palpitations, chest pains, and eventual loss of consciousness. Depending on the severity of symptoms, hospitalization may be necessary to regulate the rate and rhythm in the presence of excessive ethanal. Fortunately, unlike atrial fibrillation due to other causes, in most cases of acute alcohol-induced atrial fibrillation, it will pass just like the holiday simply by allowing the ethanol/ethanal to leave the body.  

What can you do at home to prevent or treat this syndrome? Start by removing alcoholic beverages from your holiday gatherings altogether. Should you blow past that advice, pace yourself such that your BAC never climbs above 0.07 (0.7%). Choose drinks with less alcohol content and add ice. Know that alcohol flushes water and electrolytes out of the body so avoid dehydration and keep your overall blood volume and electrolytes up by eating electrolyte rich foods and drinking water in between alcoholic beverages.

We all know that alcohol is not healthy for us, yet the desire for holiday euphoria has us indulging in this harm. If you do partake in holiday libations, remember that your heart is not the only one at risk. If you drink, do not drive.